The rise and fall of “the Internet Doc”

I must confess that while I have a great interest for things technological, I am not a fan of diagnoses through chat rooms or other cyberspace model where a doctor can “diagnose” an ailment and using the process of elimination, suggest what my ailment could be from a simple cough to pneumonia.

The reality is the internet is here to stay. I have seen the seductive powers of advertising work to the point where patients demand medication from their doctors, as opposed to wait for a doctor to recommend the same. I have also witnessed people going online to various sites on the internet to get a diagnosis (albeit broad) for anyone from a relative to him or herself to even a pet. Similarly, we are all aware of patients who order drugs online only to be duped.

While technology has its place, diagnostic medicine and treatment may not have its place on the internet. Call me old-fashioned but I believe that patients must be seen in person (not on Skype), diagnosed in person and prescribed in person.

I cannot think of any self-respecting insurance company that would insure a qualified doctor for malpractice in these circumstances or negligence should there be a dreadful mistake. At the same time, no serious individual should expect a doctor to speculate online as to what his or her health issue might be in the ethereal space now known to us as cyberspace.

It makes no sense. It is dangerous.

We do not live in the “take two aspirins and call me in the morning” philosophy, we are called to a higher responsibility, so high it can be stressful but we must prevail and be the best physicians we can be for our discerning patients. There are excellent web sources online for the layman to become an informed patient but this should not give patient or doctor a license to make ill-informed decisions. This is about as dangerous as making a diagnosis, prognosis and prescribing medication over the phone! Say Aaah….

Recent events have brought this to the fore. The use or misuse of these sites may lead to death or disability and while curiosity may lead you to attempt to self-diagnose if you are a patient, the danger of diagnosing the vulnerable as a physician is nothing short of highly irresponsible.

The implications for making such a lack of judgment is not limited to the law court but the very outstripping of your medical scrubs for evermore. Remember the Hippocratic Oath. We are dealing with living, breathing, human beings with loved ones.

It seems redundant that we should even have such a sophomoric discussion at this time. After all, us physicians are learned, intellectual, always looking for the next best thing, new treatments, exciting developments in medicine, reading the latest in various journals but we must never be complacent.

Yet doctors who should know better have been placing patients on the VCLDs (very low calorie diets) and administering HCG, knowing full well that such a drug is banned by the FDA for usage in any eight loss regimen. Much more is going on. Thus, one may be tempted to offer advice by e-mail, by Skype, online, while texting and I say this knowing full well that I am now venturing from the sublime to the utterly ridiculous. We must return to being doctors and not modern-day well-wishers in scrubs.

Let us keep our patients informed and empowered by insisting that while the internet is a good tool for research, not everything on the internet is trustworthy. Let us therefore make sure that we are not practicing online medicine or sending friends, family and potential patients to pay for a nebulous diagnosis at best and a fatal outcome at worst.

Much of what we do must focus around best practices and saving lives, not placing lives in peril. Please do note that exempt from this conversation is the development of technologies in medicine which make it easier and more practical to make diagnoses and indeed perform delicate surgeries in person, on site. That is an altogether different discussion.

Let common sense prevail. In this information age, let us inform our patients of the “pseudo-medical practices” and ensure the safety of our patients. Continue to encourage patients of all ages to take the necessary tests relative to their age, demographic and risk groupings and focus on becoming fit nations across the world. It may be a long journey but one well worth the wait. Healing does not come by the click of a mouse and “enter chat room”.